Legislative Council Thursday 30 April, 2020

Ms FORREST to LEADER of the GOVERNMENT in the LEGISLATIVE COUNCIL, Mrs HISCUTT

QUESTION 1 - COVID19 cases in Tasmania

1. Where in Tasmania was the first identified case of COVID-19?
2. What was the source of COVID-19 transmission that led to the virus arriving in NW Tasmania?
3. Were there any known or reported breaches of our border quarantine processes; and
a. If so, what ports of entry to the State

ANSWER
1. The first identified case was in Launceston.
2. As noted by Dr Veitch in the COVID-19 North West Regional Hospital Outbreak Interim Report, “the original source of infection in this outbreak was most likely to have been one (or both) of two inpatients who were admitted to the NWRH with COVID-19 acquired on a cruise ship, the Ruby Princess”
3. A response is being prepared and will be provided when available.

QUESTION TWO - Elective Surgery

With regard to the cancellation of all elective surgery in response to the COVID-19 pandemic:
1 When is it expected that elective surgery will recommence;
2 Will resumption of Category 1 elective surgery be prioritised;
3 What is the expected timeframe for recommencement of Category 1 elective surgery;
4 Will elective surgery recommence across all hospitals at the same time; and if not:
4.1 will Category 1 patients from around the State be re-assessed to ensure all Tasmanians can access urgent care as soon as possible and in a timely manner; and
4.2 how will this be undertaken?
5 What communication has and/or will be provided to patients who are waiting for procedures, including Category 1 elective surgery cases to inform them of these decisions?
Answered by: Hon Leonie Hiscutt MLC

ANSWER

During the COVID-19 pandemic, the difficult decision was made to cease most elective surgery and IVF procedures nationally.
However, the most urgent category one surgery has continued to be delivered in our hospitals.
As announced last week, the National Cabinet, acting on the advice of the Australian Health Protection Principal Committee, has made the decision to resume some other procedures in addition to this category one surgery.
The Department of Health is now working through surgery plans and capacity with local hospital management and senior clinicians, as well as the private sector.
We are not yet in the position to return to normal elective surgery levels, so this will be a gradual, progressive restart to our surgical program.
There will be close consideration of current constraints in our health system, for example with the North West outbreak and the extra pressure from that outbreak placed on the LGH, and the final decisions on the category and types of patients to be operated on will remain at the discretion of our medical professionals, and will vary from site to site.
Our hospitals and surgeons will continue to communicate with patients when their date for surgery approaches.

QUESTION THREE - Maternity Services at NWPH

With regard to maternity services at the NWPH in Burnie;
1 Will consideration be given to opening the maternity unit for just low risk women once the cleaning and re-stocking has been completed?
2 What is the expected timeline for opening of fully maternity and obstetric services?
3 Will the service continue to be operated by the THS until the State of Emergency remains in place?
3.1 If not, why not?

ANSWER

It is currently anticipated that maternity and obstetric services will re-open at the North West Private Hospital in the week commencing 4 May 2020.
I am advised earlier partial service commencement is not feasible, due to the workforce currently undergoing return to work checks, including testing, and the need for associated back-up services across the hospital to be in place to support service delivery.
While THS will continue to support service delivery across the North West campus, the contracted maternity service will be provided by the North West Private Hospital.

QUESTION FOUR - Number of People Isoloating with COVID-19

1 How many people infectious with COVID-19 have been sent home to isolate;
2 Of these people;
2.1 How many isolated in households with family, carers or housemates?
2.2 How many isolated in government provided facilities/hotels?
2.3 How many household contacts of home isolation infectious patients have been:
2.3.1 subsequently diagnosed with COVID-19;
2.3.2 hospitalised with COVID-19;
2.3.3 admitted to ICU with COVID-19;
2.3.4 died with a diagnosis of COVID-19;
2.3.5 the source of COVID-19 transmission to additional people outside their household; and
2.3.6 the source of COVID-19 transmission to staff or patients within a healthcare setting?
3 Were any COVID-19 cases related to the NW outbreak acquired from a household contact; and
3.1 If so; how many?

ANSWER

As of 28 April 2020, there were 45 active cases being managed at home.
It is not possible to provide a further breakdown at this time. However, the Department of Health is progressing work in this area and will provide Members with a fuller response as soon as it is able, noting that the current focus is on addressing the outbreak.

QUESTION FIVE - Membership of State Committee in the State Emergency

1) My question is to the Hon Leader under the Emergency Management Act 2006 are you able to provide the membership of the State Committee as per Clause 8?

ANSWER
The State Emergency Management Committee (SEMC) is established under section 8 of the Emergency Management Act 2006. The membership is as follows:
Chair
• State Emergency Management Controller - Darren Hine
Executive Officer
• Director, State Emergency Service – Andrew Lea.
Members
• Deputy Commissioner of Police (Deputy Chair) – Scott Tilyard
• Secretary, Department of Premier and Cabinet - Jenny Gale
• Secretary, Department of Health - Kathrine Morgan-Wicks
• Secretary, Department of Primary Industries, Parks, Water and Environment - Tim Baker
• Secretary, Department of State Growth - Kim Evans
• Secretary Department of Justice - Ginna Webster
• Secretary, Department of Education - Tim Bullard
• Secretary, Department of Treasury and Finance - Tony Ferrall
• Secretary, Department of Communities Tasmania - Michael Pervan
• Deputy Secretary, Department of Premier and Cabinet (State Recovery Advisor) - Craig Limkin
• Chief Officer, Tasmania Fire Service - Chris Arnol
• Director of Public Health - Mark Veitch
• Chief Executive, Ambulance Tasmania - Neil Kirby
• Director, State Emergency Service - Andrew Lea
• Chief Executive Officer, Local Government Association of Tasmania - Katrena Stephenson
• Regional Emergency Management Controllers
o Regional Emergency Management Controller - Southern Commander Tasmania Police - Anthony Ceritelli
o Regional Emergency Management Controller - Western Commander Tasmania Police - Debbie Williams
o Regional Emergency Management Controller - Northern Commander Tasmania Police - Brett Smith
• Chairs of SEMC Sub-Committees
o Chair of Capability and Capacity Sub-Committee - Deputy Chief Officer Tasmania Fire Service - Bruce Byatt
o Chair of Collaborative Leadership Sub-Committee - Commander Special Response and Counter Terrorism Tasmania Police - Joanne Stolp
o Chair of Recovery Working Group - Director, Office of Security and Emergency Management - Simon Roberts
o Chair of Risk Sub Committee – Director, State Emergency Service - Andrew Lea
• Any other person holding a position or office determined by the State Controller (nil at this point in time)
• Any other persons the State Emergency Management Controller considers appropriate (nil at this point in time)

QUESTION SIX - Pandemic Planning and Preparedness

Regarding the North West COVID-19 outbreak:
1 With regard to pandemic planning and preparedness;
a) Were PPE protocols, staff training and PPE availability consistent in all hospitals;
b) Have any concerns regarding pandemic planning and preparedness including PPE protocols, staff training and PPE availability in the NW health system been raised or did they contribute to the outbreak at NWRH?
2 What impacts, if any, did overall hospital resourcing, clinical governance and staffing have on the outbreak and its progression?
3 What infection control measures will change immediately, in the medium term and longer term, to reduce risks and to prevent a recurrence?

ANSWER
1
Ensuring our frontline staff are as well protected as possible against COVID-19 is an absolute priority for both the THS and the Tasmanian Government.

The Government has been assured that there are regular checks in health facilities to ensure supplies are being maintained throughout the day, and that PPE is being actively managed and promoted in our facilities in line with the evidence-based national COVID-19 infection prevention and control recommendations from the AHPPC.

Tasmania’s guidelines are being constantly reviewed to ensure they are meeting the needs of our services and staff, and further training is being rolled out to ensure our staff are supported.

2 and 3
The Tasmanian Government has today released the COVID-19 North West Regional Hospital Outbreak Interim Report. This report is vital to develop early epidemiological findings, so that immediate issues can be acted on, in line with best practice in outbreak management.
Importantly, the COVID-19 North West Regional Hospital Outbreak Interim Report has been made available publicly.

The Government is committed to ensuring we learn the lessons from the North West outbreak, and we will share these across our health system to that we can all continue to work to do our best to avoid similar outbreaks in the future.

The Minister has confirmed today that they have accepted all of the report’s recommendations, which includes a range of recommendations relating to governance, planning, infection control and PPE processes.

The Secretary of the Department of Health has been tasked with developing an implementation plan.

Some recommendations are being actioned very quickly and are already being implemented, including:
o Enhanced staff screening;
o Improving PPE training and communication for our staff; and
o Clarifying Return to Work processes on a statewide basis.
Other recommendations will take longer to progressively plan and implement, as in parallel to this work we are continuing to our preparations for this pandemic.

QUESTION SEVEN - West Coast Municipality

• How many positive cases have been detected in people who normally reside on the West Coast;
  • How many of these cases are currently active;
  • How many have been or are currently hospitalised with COVID-19;
  • How many have recovered; and
  • How many have died?
• How many positive cases have been detected in people who normally reside Circular Head;
  • How many of these cases are currently active;
  • How many have been or are currently hospitalised with COVID-19;
  • How many have recovered; and
  • How many have died?
• How many positive cases have been detected in people who normally reside in Waratah/Wynyard municipality;
  • How many of these cases are currently active;
  • How many have been or are currently hospitalised with COVID-19;
  • How many have recovered; and
  • How many have died?
• How many positive cases have been detected in people who normally reside in Burnie municipality;
  • How many of these cases are currently active;
  • How many have been or are currently hospitalised with COVID-19;
  • How many have recovered; and
  • How many have died?

ANSWER

As of 6pm, 28 April 2020, there were 145 confirmed cases in North West Tasmania, comprising:

• 63 active cases
• 72 recovered cases
• 10 deceased cases.

Of these, 8 are currently inpatients across the State.

Public Health Services is progressing work to look at providing a more detailed level of geographic breakdown and that will be released publicly and provided to Members once is it complete.